As we push to improve patient outcomes within corrections, there is a growing focus on raising employee licensure levels to align with best practices in healthcare. In the free world, doctors’ offices and hospitals are staffed with Licensed Practical Nurses (LPNs) who are directly overseen and supervised in-person by Registered Nurses (RNs).
What is the difference between a Licensed Practical Nurse and a Registered Nurse?
With approximately one year of education culminating in a certificate or associate degree, Licensed Practical Nurses focus on providing basic nursing care and ensuring patient comfort. Their responsibilities include reporting even minor changes in patient conditions to an RN or doctor.
Typically requiring two to three years of education, often leading to a bachelor’s degree, Registered Nurses have an expanded scope of duties. They primarily administer medications and treatments and are generally expected to apply critical thinking to more complex patient care scenarios.
The benefits of staffing corrections facilities with Registered Nurses
The lower salary expectations for LPNs sometimes appeals to county commissioners and state legislatures who have a custom of seeking less-expensive health care for inmates. Some facilities operate without any RNs on staff at all.
However, staffing mostly RNs has been shown to reduce operational costs. [1] The cost-saving benefits of an RN workforce is in no small part due to the increasing number of lawsuits facilities are facing related to LPN staffing.
In a 2015 lawsuit, the court stated: “It is predictable that placing an LPN nurse lacking the specific tools to handle the situations she will inevitably confront in the jail setting will lead to violation of the constitutional rights of inmates.” [2]
In 2023, a reality TV star sued a Michigan county alleging LPNs are unqualified to work in jail. The complaint was critical of the facility for having an LPN and argued that the inadequacy in clinical competency due to lack of education was obvious. [3]
Within our organization, internal data from 2016-2023 shows that sites with an RN versus an LPN had 84% fewer claims and 95% less in legal costs. County commissioners and state legislatures concerned with budget constraints should share this data with their insurance and risk management groups when requesting increased funding for their correctional health care programs.
While many correctional facilities employ some of the brightest, most experienced and most hardworking LPNs, the reality is that correctional facilities should be staffed (and funded) according to state licensing and accreditation boards. In Iowa, for example, an LPN’s role in correctional facilities is defined only as providing supportive and restorative care under the supervision of an RN. [4]
To stay ahead of this change, LPNs should take advantage of available scholarships and LPN to RN bridge programs, while correctional facilities should begin budgeting to pay higher wages to recruit and retain RNs, including providing education incentives for LPNs currently on staff.
Facilities looking to incentivize LPN advancement need to look no further than the National Association of Licensed Practical Nurses’ (NALPN) “Nurse Practice Standards,” which sets an expectation that “the Licensed Practical Nurse shall take advantage of continuing education and/or certification opportunities which will lead to professional development and personal growth.” [5]
A transition to an RN-dominant workforce should be seen as beneficial to patients, facilities, and ultimately, nurses.
References
1. Young J. (2024.) Advancing Correctional Healthcare: The Imperative of LPN to RN Advancement, Journal of Correctional Health Care.
2. Shadrick v. Hopkins County, Ky., 805 F.3d 724 (Ken.2015).
3. Birdsall M. (2023.) Reality TV Figure’s Lawsuit Claims He Was Denied Heart Meds during Jail Stay. Huron Daily Tribune. April 13, 2023.
4. Standards of nursing practice for licensed practical nurses. (2021). Iowa Legislature. 655—6.3(152)
5. National Association of Licensed Practical Nurses (2023). Nurse Practice Standards, NAPLN.
About the author
Spark Training is a nationally recognized center of excellence that sets the standard for training and compliance through high-quality programs and quality improvement. Spark Training was recently awarded Best Correctional Training Company 2024 – USA in the sixth annual Education and Training Awards hosted by Corporate Vision.